BACKGROUND: The domestic quantity of blood components consumed has been decreasing since 2002, but the rate of a single unit RBC transfusion (SUT) has been on the increase. In the past, a SUT was regarded as an uncesssary procedure, but currently is considered as an effective method to maintain a minimal hemoglobin concentration for physiological needs. We investigated the actual conditions of a SUT. METHODS: We analyzed 800 cases of SUTs performed at a tertiary care university hospital between March 2006 March and February 2007. The subjects of the study were divided into a surgical group (n=561) and medical group (n=239) for the purpose of RBC unit usage and were analyzed by groups and ordering departments, with an analysis of the pre and post-transfusion hemoglobin concentration and hematocrit values. The distribution according to the pre and post-transfusion hemoglobin ranges were calculated. RESULTS: The mean hemoglobin concentration increment of the surgical group was significantly lower than that of the medical group (P<0.0001) and the mean pre and post-transfusion hemoglobin concentrations of the medical group were lower than that of the surgical group (P<0.0001). Approximately 26% cases of the SUTs performed in the surgical group were appropriate, based on a post-transfusion hemoglobin concentration below 10 g/dL. In the medical group, about 75% of the SUTs were appropriate based on a pre-transfusion hemoglobin concentration below 9 g/dL. CONCLUSION: Most transfusions are decided based on various clinical situations and opinions of the clinicians. Therefore, continuous evaluation of the appropriateness of transfusion is necessary. In our study, the appropriateness of a SUT was estimated indirectly based on the pre and post-transfusion hemoglobin concentration. Consequently, policies and strategies for performing asingle unit RBC transfusion are required.
Hematocrit ; Tertiary Healthcare

Automation ; Laboratories ; Tertiary Healthcare

No abstract available.
Hematology* ; Tertiary Care Centers* ; Tertiary Healthcare* ; Thrombocytopenia*

Awareness ; Curriculum ; Hospitals, Teaching ; India ; Tertiary Healthcare

BACKGROUND: This study was conducted to survey the incidences, severity, and variables influencing depression and the correlation between pain and depression in Korean cancer patients. METHODS: The results of a survey were collected from 142 patients, 79 male and 63 female (mean age 51.9 years), who were hospitalized at a major metropolitan tertiary care hospital for cancer treatment from January to June of 1999. Factors of depression and the level of pain were examined by a self-reported survey employing the Korean version of the Beck Depression Inventory (BDI) and an abridged version of the Brief Pain Inventory respectively. Demographic and clinical characteristics of patients were compiled by reviewing their medical records. The difference in the level of depression among patient groups was analyzed with the t-test and ANOVA, and the correlation between variables with the Pearson correlation coefficient. RESULTS: The mean scores of the worst pain for the last 24-hours was 6.1 +/- 2.2, the average pain for the last 24-hours 4.4 +/- 1.9, and the mean scores of pain at the time of the survey was 3.5 +/- 2.3, while the mean scores of the least pain for the last 24 hours was 2.3 +/- 1.8. The mean BDI scores were 23.7 +/- 1.0, and 55.6% of the patients were found to be in depression (cut off point 21). Scores of depression for cancer patients were higher than in the normal population. The correlations between the worst pain for the last 24 hours and depression, average pain for the last 24-hours and depression, pain at present and depression were significant. Significant differences were found among groups of cancer patients with pain with respect to gender, level of education, and ECOG. There was a significant positive correlation between depression and pain. CONCLUSIONS: More than 50% of cancer patients with pain were suffering from depression. The variables like the degree of pain, gender, level of education, ECOG, and age were significantly related to depression in cancer patients. The findings of this study could be used for identifying high-risk patients in need of intervention and planning effective therapeutic strategies for cancer patients.
Depression* ; Education ; Female ; Humans ; Incidence ; Male ; Medical Records ; Tertiary Healthcare

BACKGROUND: Respiratory infection in pregnancy can cause various side effects and affect the fetus. Therefore, efforts to prevent infection during pregnancy are essential. This study investigated knowledge and compliance regarding the prevention of respiratory infection among pregnant women. METHODS: A survey was conducted on May 10, 2012 on 300 pregnant women who attended a maternity school education program in a tertiary care hospital. The responses of 259 women were collected and analyzed. RESULTS: Only 2 women (0.8%) had been educated about respiratory infection prevention methods, while 106 (40.9%) experienced respiratory infection during pregnancy. The mean score of respiratory infection prevention knowledge was 11.63 out of 15 points (percentage of correct answers: 77.5%). The mean score for compliance to respiratory infection prevention was 32.34 out of 52 points (percentage of practice: 62.19%). Knowledge and compliance were found to be positively correlated. CONCLUSION: Although many pregnant women experience respiratory infection during pregnancy, few have opportunities to be educated about prevention. Thus, the positive correlation between knowledge and compliance highlights the need for respiratory infection prevention education programs.
Compliance ; Female ; Fetus ; Humans ; Pregnancy ; Pregnant Women ; Tertiary Healthcare

BACKGROUND: Apart from devaluing the basic skills of history taking and clinical examinations, the indiscriminate use of STAT tests is increasing in hospital practice. The purpose of this study is to evaluate the appropriateness of the STAT test requests in a tertiary care teaching university hospital. METHODS: We assessed the reasons for the STAT test requests on 644 patients (inpatients 338, emergency room patients 215, and outpatients 91), totaling 1,681 requests, during a 2 week period (between August 8 to 22, 1996) by discussing with the clinicians and nurses and/or reviewing the patient's records. RESULTS: Of 1,681 requests, 779 (46.3%) were considered inappropriate according to the criteria used to define categories. Inappropriate requests were detected in 45.1% (265/588) in wards, 49.0% (446/910) in the emergency room, and 37.2% (68/183) in the out patient department. The frequency of requests during the day showed two peaks: the first between 10 and 11 a.m., and the second between 3 and 4 p.m., which appears to indicate that the STAT tests are often requested for the convenience of the physician rather than true need of the patients. CONCLUSIONS: Many STAT tests are requested for reasons other than true emergencies. Inconsiderate, wasteful, and disruptive STAT test requests imposed an extra burden on the laboratory and resulted in a delay of reports on other true STAT or routine tests. Strategies to reduce the number of inappropriate STAT tests should be established in order to reserve the emergency service for situations of true need.
Emergencies ; Emergency Service, Hospital ; Humans ; Outpatients ; Tertiary Healthcare

BACKGROUND: Single egg-based Ogawa medium is used for mycobacterial culture in nearly all tertiary care or medical school-affiliated hospital in Korea. However, it is expected that some mycobacteria would grow so lately or never in only one media, even if mycobacteria are present sufficiently in the specimen. To estimate the efficiency of inoculation to two or more egg-based media for isolation of mycobacteria, positive culture rates and detection time were compared among three media. METHODS: 193 clinical specimens, which referred to laboratory of Pusan National University Hospital for 2 months, including 123 specimens of patients with mycobacteriosis, were processed and inoculated to Eiken, VITE and KT media. The isolates were identified and classified to Mycobacterium tuberculosis and non-tuberculous mycobacteria (NTM) by AccuProbe method. The positive culture results were analyzed by McNemar test and t-test. RESULTS: M. tuberculosis and NTM were isolated in 65 (34.0%) and 14 (7.4%) specimens, resulting in positive culture rates of 41.4%. Of the 123 patients' specimens, 63 cases were positive in culture of VITE media, which were significantly higher than 50 cases of Eiken and 45 cases of KT media. In 43 positive-stained specimens, twelve to twenty samples (29.3-48.8%) failed to grow in at least one media. The colonies were visible at 24.9 to 30.7 days after inoculation, and VITE and KT media detected visible colonies 4.5 and 2.5 days more rapidly than Eiken media, respectively. CONCLUSIONS: Inoculation to two or more egg-based media is useful for increasing culture positivity and early detection of colonies for mycobacterial culture.
Busan ; Humans ; Korea ; Mycobacterium tuberculosis ; Tertiary Healthcare ; Tuberculosis

PURPOSE: The purpose of this study was to identify awareness of hospital safety culture (AHSC) and safety activities (SA) of workers in a tertiary care hospital, and the factors influencing safety activities. METHODS: 303 Participants from the tertiary care hospital in Seoul were invited. Collected data were analyzed using SPSS 18.0. RESULTS: The level of AHSC and SA was 3.61 and 4.17, respectively. There were differences between AHSC and SA according to gender, religion, employment status, job class, working period, safety education, need for safety education, and number of safety accident reports. There was a positive relationship between AHSC and SA. The factors influencing SA were communication and process, employment status, and safety accident reports. CONCLUSION: AHSC and SA are important factors to improve hospital safety, as well as increasing chances to receive hospital accreditation.
Accreditation ; Education ; Employment ; Humans ; Safety Management* ; Seoul ; Tertiary Healthcare*

BACKGROUND: Chronic spontaneous urticaria is a debilitating disease for the patients and often considered by the doctors a very difficult disease to treat. In 2009 the European Academy of Allergy and Clinical Immunology/Global Allergy and Asthma European network/European Dermatology Forum/World Allergy Organization (EAACI/GA2LEN/EDF/WAO) published a revised version of the guidelines for the treatment of urticaria which included an algorithm for the treatment. OBJECTIVE: The objective of this study was to examine the clinical effect and the practical use of the algorithm. METHODS: The study was performed as a case-series study of all newly referred patients to our urticaria clinic over a period of 18 months. RESULTS: Our results show that the single most important and efficient treatment of urticaria patients is up dosing non-sedating antihistamines as recommended by the EAACI/GA2LEN/EDF/WAO guidelines. We did not find any predicting factors for responders to the antihistamine treatment, but about one third of the patients did not respond to the up-dosing of the antihistamines. CONCLUSION: Antihistamines seems to be the most efficient treatment for urticaria; other treatments such as montelukast, azathioprine, and mycophenolate mofetil may also be used, but only in combination with antihistamines and only in the case of an independent antihistamines treatment failure. The EAACI/GA2LEN/EDF/WAO guideline for the treatment of urticaria offers an efficient and simple guidelines for the treatment of urticaria.
Asthma ; Azathioprine ; Dermatology ; Histamine Antagonists ; Humans ; Hypersensitivity ; Tertiary Care Centers* ; Tertiary Healthcare* ; Treatment Failure ; Urticaria*